title: Clinical experience with laparoscopic radical nephrectomy for renal cell carcinoma.
abstract: OBJECTIVE
  We performed a comparative study of laparoscopic radical nephrectomy (LRN) and open radical nephrectomy (ORN) for renal cell carcinoma, and a comparative study of transperitoneal (LRN-TP) versus retroperitoneal LRN (LRN-RP) for renal cell carcinoma.
  
  
  METHODS
  A total of 100 patients underwent radical nephrectomy for stage T1 and T2 disease. Of the 100 cases, 34 (34.0%) were treated with LRN-TP, 33 (33.0%) with LRN-RP, and 33 (33.0%) with ORN. Each group was reviewed with respect to complications, postoperative convalescence, and the relationship between body mass index and operative time.
  
  
  RESULTS
  Mean operative times of LRN-TP, LRN-RP and ORN were 305.7, 296.2, and 218.1 min, and mean blood losses were 236.3, 101.7, and 690.5 ml, respectively. Body mass index and mean operative time exhibited equilateral correlation in the three groups. In one case (1.5%) of LRN (67 cases), conversion to open surgery was necessary due to bleeding, and LRN-TP was performed. In one case (1.5%), intraoperative complications occurred but could be managed laparoscopically. Three cases (9.1%) of ORN required blood transfusion.
  
  
  CONCLUSIONS
  LRN results in less blood loss, less postoperative pain, quicker oral intake, shorter hospitalization, and a more rapid recovery than ORN, although LRN requires longer operative time than ORN.
authors.affiliation: Department of Urology, Osaka University Graduate School of Medicine, Suita, Japan. tsujihata@uro.med.osaka-u.ac.jp
authors.forename: Masao
authors.initials: M
authors.lastname: Tsujihata
authors.forename: Norio
authors.initials: N
authors.lastname: Nonomura
authors.forename: Chikahiro
authors.initials: C
authors.lastname: Momohara
authors.forename: Kazuo
authors.initials: K
authors.lastname: Nishimura
authors.forename: Akira
authors.initials: A
authors.lastname: Tsujimura
authors.forename: Akihiko
authors.initials: A
authors.lastname: Okuyama
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics / Q000627:therapeutic use; D016063:Blood Loss, Surgical / Q000517:prevention & control; D015992:Body Mass Index; D002292:Carcinoma, Renal Cell / Q000473:pathology / Q000601:surgery*; D004435:Eating; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology / Q000601:surgery*; D010535:Laparoscopy / Q000009:adverse effects; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000009:adverse effects / Q000379:methods*; D010149:Postoperative Pain / Q000209:etiology / Q000517:prevention & control; D013997:Time Factors; D016896:Treatment Outcome; D016138:Walking
chemical_list: D000700:Analgesics